Changes in Plasma Endotoxin Level in the Perioperative Period, and Relation between Preoperative Level of Serum Proteins and Endotoxin Level

Tetsuji Fujita, Makoto Odaka, Miwako Matsumoto, Kenji Sakurai

First Department of Surgery, The Jikei University School of Medicine

The purpose of this study was to examine the changes in plasma endotoxin levels in the perioperative period, and to investigate the effect of nutritional status on endotoxin levels. Portal blood samples were obtained from 37 patients who underwent abdominal surgery, and the endotoxin levels were measured. The relationship between portal blood endotoxin level and preoperative serum albumin level was examined. In the 17 consecutive patients enrolled in this study, preoperative levels of several rapid transport proteins were measured, and their relation to portal blood endotoxin levels was determined. Furthermore, perioperative changes in the peripheral venous plasma endotoxin level were examined. No significant correlation was found between preoperative serum albumin level and portal blood endotoxin level, but the preoperative serum level of the third component of complement or haptoglobin was negatively correlated with the portal blood endotoxin level. The endotoxin level in plasma obtained during surgery were about 3 times higher than the preoperative values. These data suggest that malnutrition predisposes patients to increased endotoxin levels in portal blood during the abdominal surgery.

Key words
changes in endotoxin levels in the perioperative period, effect of nutritional status on endotoxin levels

Reprint requests
Tetsuji Fujita First Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
May 11, 1993

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